1003 Application

Uniform Residential Loan Application

Borrower

Co-Borrower

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Amortization Type:

Conventional Conventional

USDA/Rural USDA/Rural Housing Service

Other (explain)

Agency Case Number

Lender Case Number

Mortgage Applied for:

Fixed Rate

GPM

Other (explain)

ARM (type)

Interest Rate %

No. of Months

Amount $

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address (street, city, state & ZIP)

No. of Units

Legal Description of Subject Property (attach description if necessary)

Year Built

Purpose of Loan

Purchase

Refinance

Construction

Other (explain:)

Construction-Permanent

Property will be:

Secondary Residence

Primary Residence

Investment

Complete this line if construction or construction-permanent loan.

Year Lot Acquired

Original Cost

Amount Existing Liens

(a) Present Value of Lot

(b) Cost of Improvements

Total (a + b)

Complete this line if this is a refinance loan.

Year Acquired

Original Cost

Amount Existing Liens

Purpose of Refinance

Cost

Describe Improvements

made

to be made

Title will be held in what Name(s):

Manner in which Title will be held

Estate will be held in:

Fee Simple

Leasehold

Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)

(show expiration date)

Borrower

III. BORROWER INFORMATION

Co-Borrower

Borrower’s Name (include Jr. or Sr. if applicable)

Social Security Number

Home Phone (incl. area code)

DOB (mm/dd/yyyy)

Yrs. School

Present Address (street, city, state, ZIP)

Mailing Address, if different from Present Address

Marital status

Married

Unmarried (include single, divorced, widowed)

Separated

Property status

Own

Rent

Dependents (not listed by Co-Borrower)

Ages:

No:

No. Yrs

If residing at present address for less than two years, complete the following:

Former Address (street, city, state, ZIP)

No. Yrs

Property status

Own

Rent

Co-Borrower’s Name (include Jr. or Sr. if applicable)

Social Security Number

Home Phone (incl. area code)

DOB (mm/dd/yyyy)

Yrs. School

Present Address (street, city, state, ZIP)

Mailing Address, if different from Present Address

Marital status

Married

Unmarried (include single, divorced, widowed)

Separated

Property status

Own

Rent

Dependents (not listed by Co-Borrower)

Ages:

No:

No. Yrs

If residing at present address for less than two years, complete the following:

Former Address (street, city, state, ZIP)

No. Yrs

Property status

Own

Rent

Borrower

IV. EMPLOYMENT INFORMATION

Co-Borrower

Borrower

Name & Address of Employer

Self- Employed

Yrs on this job

Yrs employed in this line of work/profession

Position/Title/Type of Business

Business Phone (incl area code)

If employed in current position for less than two years or if currently employed in more than one position, complete the following:

Name & Address of Employer

Self Employed

Date (from)

Date (To)

Monthly Income

Position/Title/Type of Business

Business Phone (incl area code)

Co-Borrower

Name & Address of Employer

Self- Employed

Yrs on this job

Yrs employed in this line of work/profession

Position/Title/Type of Business

Business Phone (incl area code)

If employed in current position for less than two years or if currently employed in more than one position, complete the following:

Name & Address of Employer

Self Employed

Date (from)

Date (To)

Monthly Income

Position/Title/Type of Business

Business Phone (incl area code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Gross Monthly Income

Borrower Base Empl. Income*

Co-Borrower Base Empl. Income*

Total Base Empl. Income*

Borrower Overtime

Co-Borrower Overtime

Total Overtime

Borrower Bonuses

Co-Borrower Bonuses

Total Bonuses

Borrower Commissions

Co-Borrower Commissions

Total Commissions

Borrower Dividends/Interest

Co-Borrower Dividends/Interest

Total Dividends/Interest

Borrower Net Rental Income

Co-Borrower Net Rental Income

Total Net Rental Income

Borrower Other (amt)

Co-Borrower Other (amt)

Total Other (amt)

Borrower before completing, see the notice in "describe other income," below:

Co-Borrower before completing, see the notice in "describe other income," below:

Total before completing, see the notice in "describe other income," below:

Borrower Total

Co-Borrower Total

Total Total

Combined Monthly Housing Expense

Present Rent

Proposed Rent

Present First Mortgage (P&I)

Proposed First Mortgage (P&I)

Present Other Financing (P&I)

Proposed Other Financing (P&I)

Present Hazard Insurance

Proposed Hazard Insurance

Present Real Estate Taxes

Proposed Real Estate Taxes

Present Mortgage Insurance

Proposed Mortgage Insurance

Present Homeowner Assn. Dues

Proposed Homeowner Assn. Dues

Present Total

Proposed Total

Present Other

Proposed Other

* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
** Describe Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not choose to have it considered for repaying this loan.

B/C

Description

Monthly Amount

This Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and Schedules are required. If the Co-Borrower section was completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also. Completed

Jointly

Not Jointly

ASSETS Description

Cash deposit toward purchase held by:

Cash or Market Value

Liabilities and Pledged Assets. List the creditor's name, address, and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities, which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.

List checking and savings accounts below

Name and address of Bank, S&L, or Credit Union

Acct. no.

Stocks & Bonds (Company name/ number & description)

Life insurance net cash value Face amount: $

Subtotal Liquid Assets

Vested interest in retirement fund

Automobiles owned (make and year)

Other Assets (itemize)

Real estate owned (enter market value from schedule of real estate owned)

Net worth of business(es) owned (attach financial statement)

Total Assets a.

LIABILITIES

Name and address of Company

Acct. no.

Alimony/Child Support/Separate Maintenance Payments Owed to:

Job-Related Expense (child care, union dues, etc.)

Total Monthly Payments

Net Worth (a minus b):

Total Liabilities b.

Monthly Payment & Months Left to Pay

Payment

Months

Unpaid Balance

Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)

Property Address

(enter S if sold, PS if pending sale or R if rental being held for income)

Type of Property

Present Market Value

Amount of Mortgages & Liens

Gross Rental Income

Mortgage Payments

Net Rental Income

Insurance, Maintenance, Taxes & Misc.

Type of Property

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):

Alternate Name

Creditor Name

Account Number

VII. DETAILS OF TRANSACTION

Purchase price

Alterations, improvements, repairs

Land (if acquired separately)

Refinance (incl. debts to be paid off)

Estimated prepaid items

Estimated closing costs

PMI, MIP, Funding Fee

Discount (if Borrower will pay)

Total costs (add items a through h)

Subordinate financing

Borrower's closing costs paid by Seller

Loan amount (exclude PMI, MIP, Funding Fee financed)

PMI, MIP, Funding Fee financed

Loan amount (add m & n)

Cash from/to Borrower (subtract j, k, l & o from i)

Other Credits (explain)

VIII. DECLARATIONS

If you answer "Yes" to any questions a through i, please use continuation sheet for explanation

Borrower

Are there any outstanding judgments against you? (Borrower)

Yes

Have you been declared bankrupt within the past 7 years? (Borrower)

Yes

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? (Borrower

Yes

Are you a party to a lawsuit? (Borrower)

Yes

Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes," provide details, including date, name, and address of Lender, FHA or VA case number, if any, and reasons for the action.) (Borrower)

Yes

Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," give details as described in the preceding question. (Borrower)

Yes

Are you obligated to pay alimony, child support, or separate maintenance? (Borrower)

Yes

Is any part of the down payment borrowed? (Borrower)

Yes

Are you a co-maker or endorser on a note? (Borrower)

Yes

Are you a U.S. citizen? (Borrower)

Yes

Are you a permanent resident alien? (Borrower)

Yes

Do you intend to occupy the property as your primary residence? If "Yes," complete question m below. (Borrower)

Yes

Have you had an ownership interest in a property in the last three years? (Borrower)

Yes

What type of property did you own—principal residence (PR), second home (SH), or investment property (IP)? (Borrower)

Yes

How did you hold title to the home—solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O) (Borrower)

Yes

Co-Borrower

Are there any outstanding judgments against you? (Co-Borrower)

Yes

Have you been declared bankrupt within the past 7 years? (Co-Borrower)

Yes

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? (Co-Borrower)

Yes

Are you a party to a lawsuit? (Co-Borrower)

Yes

Are you obligated to pay alimony, child support, or separate maintenance? (Co-Borrower)

Yes

Is any part of the down payment borrowed? (Co-Borrower)

Yes

Are you a co-maker or endorser on a note? (Co-Borrower)

Yes

Are you a U.S. citizen? (Co-Borrower)

Yes

Are you a permanent resident alien? (Co-Borrower)

Yes

Do you intend to occupy the property as your primary residence? If "Yes," complete question m below. (Co-Borrower)

Yes

Have you had an ownership interest in a property in the last three years? (Co-Borrower)

Yes

What type of property did you own—principal residence (PR), second home (SH), or investment property (IP)? (Co-Borrower)

Yes

How did you hold title to the home—solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O) (Co-Borrower)

Yes

IX. ACKNOWLEDGEMENT AND AGREEMENT

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described in this application; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whether or not the Loan is approved; (7) the Lender and its agents, brokers, insurers, servicers, successors, and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the Lender, its servicers, successors or assigns may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Acknowledgement. Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.

Borrower

Date

Co-Borrower

Date

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

BORROWER

I do not wish to furnish this information

Ethnicity:

Hispanic or Latino

Not Hispanic or Latino

Race

American Indian or Alaska Native

Asian

Black or African American

Native Hawiian or Other Pacific Islander

White

Sex

Female

Male

CO-BORROWER

I do not wish to furnish this information

Ethnicity:

Hispanic or Latino

Not Hispanic or Latino

Race

American Indian or Alaska Native

Asian

Black or African American

Native Hawiian or Other Pacific Islander

White

Sex

Female

Male

To be Completed by Loan Originator

This information was provided

In a face-to-face interview

In a telephone interview

By the applicant and submitted by fax or mail

By the applicant and submitted by e-mail or the internet

Loan Originator

Loan Originator Identifier

Date

Loan Originator's phone number (including area code):

Loan Origination Company Identifier

Loan Origination Company's Name:

CONTINUATION SHEET/RESIDENTIAL LOAN APPLICATION

Use this continuation sheet if you need more space to complete the Resedential Loan Application. Mark B for Borrower or C for Co-Borrower

I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.

Borrower

Signature

Sign Here

Date

Co-Borrower

Signature

Sign Here

Date

1003 Application

Uniform Residential Loan Application

Gross Monthly Income

Combined Monthly Housing Expense

ASSETS Description

Cash or Market Value

Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):

In Business Since 1980

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